Vital pulp therapy (VPT), including direct pulp capping and therapeutic pulpotomy, has gradually become a more commonly utilized treatment option internationally in the last two decades. This is largely due to a significant improvement in outcomes with more modern tricalcium silicate materials compared to calcium hydroxide, accompanied by a trend towards minimally invasive endodontic approaches. However, there are several obstacles to the adoption of VPT as a commonplace treatment modality in the United States. One is the economic factors involved, including lower reimbursement rates for VPT compared to traditional root canal therapy (RCT), as well as variability between states concerning insurance coverage and reimbursements for VPT. This table clinic will examine cost-effectiveness and reimbursement issues relative to VPT. In addition, it will discuss how VPT is covered by Medicaid and how coverage and reimbursement vary for children and adults in 10 states. Finally, there will be a presentation of the pros and cons of the general dentist or the endodontist performing the VPT.
